Psyche versus soma: Historical evolution of beliefs about nausea and vomiting during pregnancy

Abstract

Nausea and vomiting in pregnancy (NVP) can have both a major physiological and psychological impact on some women, thus profoundly altering their lives. This paper offers a historical approach to descriptive, observational and empirical research related to the problem. The multitude of research is summarized in three tables representing three chronological eras. The early Somatic era (until 1929) is presented in the first table and describes theories which were originally considered to be reflexive or toxemic in nature. The Intrapsychic era (1930-1980) is presented in the second table which describes theories considered to be neurotic in origin. The Metabolic and Social Stress era (1981-present) is presented in the last table which describes the evolution of all three major etiological theories as well as demographic characteristics of those most likely to experience NVP. While each of the three major view points continues to evolve and undergo refinement, the cause remains obscure. An extraordinary number of interventions have been recorded over the years and most have been deemed effective by those who introduced them. In spite of this, few women report complete relief following any treatment. It is recommended that areas of future research include the development of a valid and reliable tool that quantifies symptoms; the accumulation of knowledge about the actual experience of women themselves with NVP; and the use of randomly assigned controlled studies, double-blind when possible, to test commonly used non-pharmaceutical interventions.